LETTER REQUESTING INFORMATION
Date ______________________
Office of the Secretary of State Jefferson City Office 210 State Capitol P.O. Box 778 Jefferson City, Missouri 65102 On the lines below, please provide the name and address of the registered agent, owner, or fictitious name of the company, business or corporation that is doing business in the State of Missouri. ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________
___________________________________ Signature ___________________________________ Print Full Name ___________________________________ Print Address ___________________________________
INSTRUCTION:
Attach a check for $10.00 made payable to the Secretary of State, and enclose a self-addressed, stamped envelope with this letter.
CCAC94 Rev. 03/95